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Tirupathi SP, Afnan L, Alahari S, Challa R. Clonidine versus Adrenaline as an Adjunct to Lignocaine on Haemodynamic Parameters during Nerve Block for Third Molar Surgical Removal - A Systematic Review and Meta-Analysis. Ann Maxillofac Surg 2022; 12:203-211. [PMID: 36874780 PMCID: PMC9976844 DOI: 10.4103/ams.ams_149_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/19/2022] [Accepted: 11/13/2022] [Indexed: 01/12/2023] Open
Abstract
Background Adrenaline or clonidine is used as adjuncts in conjunction with lignocaine to improve the depth of local anaesthesia in dental procedures. Objectives This systematic review and meta-analysis intends to compare the haemodynamic parameters when clonidine or adrenaline is used in conjunction with lignocaine for third-molar surgical removal. Data Sources Cochrane, PubMed and Ovid SP databases were searched using "MeSH" terms (((nerve block) OR (IANB)) AND ((clonidine) OR (adrenaline))) AND (lignocaine). Study Eligibility Criteria Clinical studies where Clonidine + lignocaine and Adrenaline + lignocaine were compared directly during nerve block administration exclusively for third molar surgical removal were selected. Participants Study Appraisal This current systematic review is registered in Prospero database CRD42021279446. Two independent reviewers were involved in collection, segregation and analysis of electronic data. The data were compiled in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Search was conducted till June 2021. Synthesis Methods Qualitative analysis of the selected articles was performed for systematic review. Meta-analysis is performed using RevMan 5 Software. Heterogeneity through the I2 statistics. Change in the haemodynamic parameters was the primary outcome evaluated, and secondary outcomes evaluated were onset and duration of anaesthesia in both the groups. Results In all databases, 1141 records were screened, out of which a total of 21 articles were included for the evaluation for full-text analysis. Out of these, 16 articles were excluded and 5 articles were included for the final systematic review. Meta-analysis was performed only for 4 studies. Conclusion Amongst the evaluated haemodynamic parameters, there was a significant reduction in the heart rate (baseline to intraoperative period) in clonidine and lignocaine groups than in adrenaline and lignocaine groups during nerve block administration for third molar surgical removal. There was no significant difference between other primary and secondary outcomes evaluated. Limitations Blinding was not performed in all the studies, randomisation was performed in only three studies. The volume of local anaesthesia deposited varied in the studies (2 mL in three studies and 2.5 mL in two studies). Most of the studies (n = 4) were evaluated on normal adults and only one study evaluated mild hypertensive patients.
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Affiliation(s)
- Sunny Priyatham Tirupathi
- Department of Pedodontics and Preventive Dentistry, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Lamea Afnan
- Department of Public Health Dentistry, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Swetha Alahari
- Department of Pedodontics and Preventive Dentistry, Dr. Hegdewar Smruti Rugna Seva Mandals Dental College and Hospital, Parola, Maharashtra, India
| | - Ramasubbareddy Challa
- Department of Pedodontics and Preventive Dentistry, Dr. Hegdewar Smruti Rugna Seva Mandals Dental College and Hospital, Parola, Maharashtra, India
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Naphthalene vs. Benzene as a Transmitting Moiety: Towards the More Sensitive Trifluoromethylated Molecular Probes for the Substituent Effects. Molecules 2022; 27:molecules27134173. [PMID: 35807416 PMCID: PMC9268607 DOI: 10.3390/molecules27134173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023] Open
Abstract
The application of DFT computational method (B3LYP/6-311++G(d,p)) to mono- and poly(CF3)substituted naphthalene derivatives helps to study changes in the electronic properties of these compounds under the influence of 11 substituents (-Br, -CF3, -CH3, -CHO, -Cl, -CN, -F, -NH2, -NMe2, -NO2, and -OH) to confront substituent effects in naphthalene with an analogous situation in benzene. This paper shows the dependencies of theoretically calculated SESE (Substituent Effect Stabilization Energy) values on empirically determined, well-defined Hammett-type constants (σp, σm, R, and F). Described poly(CF3)substituted derivatives of naphthalene are, so far, the most sensitive molecular probes for the substituent effects in the aromatic system. The presence of the trifluoromethyl groups of such an expressive nature significantly increases the sensitivity of the SESE to changes caused by another substitution. Further, the more -CF3 groups are attached to the naphthalene ring, the more sensitive the probe is. Certain groups of probes show additivity of sensitivity: the obtained sensitivity relates to the sum of the sensitivities of the mono(CF3)substituted probes.
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Bogaevskaya O, Ignatova E, Yumashev A. Psychodiagnostics as a Mandatory Element of Patient Protocols in Dentistry. J Int Soc Prev Community Dent 2021; 11:389-396. [PMID: 34430499 PMCID: PMC8352061 DOI: 10.4103/jispcd.jispcd_60_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/12/2021] [Accepted: 05/06/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives: This study aims at performing psychodiagnostics of the patients` condition with removable and fixed dentures both before and after dental treatment. Materials and Methods: The first group included 200 patients with fixed-type dentures, and the second group consisted of 200 patients with removable dental devices. The control group included 200 patients with healthy teeth. All patients were subjected to Fere’s skin-galvanic reaction procedure. Patients also filled out the Dental Status Questionnaire and were then tested following the Spielberger-Hanin Scale. For a comparison of differences, a two-sample t-test for independent samples was used. The Pearson correlation between features was calculated considering their distribution as normal. Results: In the control group, the hemispheric activity index increased 1.1 times after treatment. In Group 2, following the dental status questionnaire, the index of hemispheric activity increased 1.3 times in males with a positive emotional mood (P ≤ 0.01). A 2.2-fold and 2.1-fold (P ≤ 0.01) increase was observed among female and male patients with a negative emotional mood in Group 2, respectively. After the treatment, the hemispheric activity index in Group 1 increased by 1.1 times for males with a positive mood (P ≤ 0.01) and by 1.2 times for male and female patients with a negative mood (P ≤ 0.05). Direct correlation was recorded between the increase in the number of scores and emotional mood among males and females from Group 1 (0.72 and 0.73, respectively). After the survey, a correlation was established between the values of the hemispheric activity index and the increase in scores among males (0.82) and females (0.81). There was also a connection between the increase in scores and the level of personal anxiety in both male (0.57) and female (0.66) patients, as well as between the increase in scores and the level of reactive anxiety (0.56 and 0.57, respectively). Conclusions: Changes in the hemispheric activity index were shown to be related to the patient’s dental condition questionnaire. Besides, there is a relationship with the type of dental service. The practical application of this study implies that more reliable information about the patient’s satisfaction with the quality of dental care provided can be obtained using not only standard psychodiagnostic methods but also questionnaires on the patient’s dental status. Once the survey is completed and the data obtained analyzed, it is possible to define the correct strategy to restore the patient’s physical and mental health after dental treatment.
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Affiliation(s)
- Oxana Bogaevskaya
- Department of Nursing, Peoples' Friendship University of Russia, Moscow, Russian Federation
| | - Ekaterina Ignatova
- Department of General and Clinical Psychology, Perm State University, Perm, Russian Federation
| | - Alexei Yumashev
- Department of Prosthetic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
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Araújo JDO, Bergamaschi CDC, Lopes LC, Guimarães CC, de Andrade NK, Ramacciato JC, Motta RHL. Effectiveness and safety of oral sedation in adult patients undergoing dental procedures: a systematic review. BMJ Open 2021; 11:e043363. [PMID: 33495257 PMCID: PMC7839856 DOI: 10.1136/bmjopen-2020-043363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES It can be challenging to manage patients who are anxious during dental procedures. There is a lack of evidence regarding the effectiveness and safety of oral sedation in adults. This study evaluated the effectiveness and safety of oral sedation in patients undergoing dental procedures. DESIGN Systematic review. METHODS Randomised clinical trials (RCTs) compared the oral use of benzodiazepines and other medications with a placebo or other oral agents in adult patients. A search of the Cochrane (CENTRAL), MEDLINE (via Ovid), EMBASE (via Ovid) and Cumulative Index to Nursing and Allied Health Literature (via Ovid) databases was conducted, without any restrictions on language or date of publication. The primary outcomes included the adverse effects and anxiety level. The secondary outcomes included sedation, satisfaction with the treatment, heart rate, respiratory rate, blood pressure and oxygen saturation. Reviewers, independently and in pairs, assessed each citation for eligibility, performed the data extraction and assessed the risk of bias. A narrative synthesis of the data was provided. RESULTS A number of RCTs (n=327 patients) assessed the use of benzodiazepines (n=9) and herbal medicines (n=3). We found good satisfaction with treatment after the use of midazolam 7.5 mg or clonidine 150 µg and reduced anxiety with alprazolam (0.5 and 0.75 mg). Midazolam 15 mg promoted greater anxiety reduction than Passiflora incarnata L. 260 mg, while Valeriana officinalis 100 mg and Erythrina mulungu 500 mg were more effective than a placebo. More patients reported adverse effects with midazolam 15 mg. Diazepam 15 mg and V. officinalis 100 mg promoted less change in the heart rate and blood pressure than a placebo. CONCLUSIONS Given the limitations of the findings due to the quality of the included studies and the different comparisons made between interventions, further RCTs are required to confirm the effectiveness and safety of oral sedation in dentistry. PROSPERO REGISTRATION NUMBER CRD42017057142.
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Affiliation(s)
- Jimmy de Oliveira Araújo
- Division of Pharmacology, Anesthesiology and Therapeutics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, Brazil
| | | | - Luciane Cruz Lopes
- Department of Pharmaceutical Sciences, Universidade da Sorocaba, Sorocaba, Brazil
| | - Caio Chaves Guimarães
- Division of Pharmacology, Anesthesiology and Therapeutics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, Brazil
| | - Natalia Karol de Andrade
- Division of Pharmacology, Anesthesiology and Therapeutics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, Brazil
| | - Juliana Cama Ramacciato
- Division of Pharmacology, Anesthesiology and Therapeutics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, Brazil
| | - Rogério Heládio Lopes Motta
- Division of Pharmacology, Anesthesiology and Therapeutics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, Brazil
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Melini M, Forni A, Cavallin F, Parotto M, Zanette G. Conscious sedation for the management of dental anxiety in third molar extraction surgery: a systematic review. BMC Oral Health 2020; 20:155. [PMID: 32466796 PMCID: PMC7254703 DOI: 10.1186/s12903-020-01136-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/07/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Dental anxiety is a condition associated with avoidance of dental treatment and increased medical and surgical risks. This systematic review aims to summarize available evidence on conscious sedation techniques used for the management of Dental anxiety in patients scheduled for third molar extraction surgery, to identify best approaches and knowledge gaps. METHODS A comprehensive search was conducted including MEDLINE/Pubmed, EMBASE, SCOPUS, clinicaltrials.gov and the Cochrane Database of Systematic Reviews through March 2019. Only randomized controlled trials were included. PRISMA guidelines were followed. Risk of bias was appraised as reported in the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS Seventeen RCTs with a total of 1788 patients were included. Some aspects limited the feasibility of a meaningful meta-analysis, thus a narrative synthesis was conducted. Conscious sedation was associated with improvement in Dental anxiety in six studies. One study reported lower cortisol levels with midazolam vs. placebo, while another study found significant variation in perioperative renin levels with remifentanil vs. placebo. CONCLUSIONS This review found inconclusive and conflicting findings about the role of Conscious sedation in managing Dental anxiety during third molar extraction surgery. Relevant questions remain unanswered due to the lack of consistent, standardized outcome measures. Future research may benefit from addressing these limitations in study design.
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Affiliation(s)
- Matteo Melini
- Oral surgery and Implantology - Department of biomedical and neuromotor science (DIBINEM), University of Bologna, Via San Vitale 59, 40125, Bologna, Italy. .,Sedation and Emergency in Dentistry Human Centered Project (HCP), The holistic treatment of the dental patient - University of Padua, Via Giustiniani 2, 35128, Padova, Italy.
| | - Andrea Forni
- Sedation and Emergency in Dentistry Human Centered Project (HCP), The holistic treatment of the dental patient - University of Padua, Via Giustiniani 2, 35128, Padova, Italy
| | | | - Matteo Parotto
- Department of Anesthesia and Pain Management and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
| | - Gastone Zanette
- Department of Neurosciences, Dentistry Section, Chair of Dental Anesthesia, University of Padua, Via Giustiniani 2, 35128, Padova, Italy
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Gándola YB, Fontana C, Bojorge MA, Luschnat TT, Moretton MA, Chiapetta DA, Verstraeten SV, González L. Concentration-dependent effects of sodium cholate and deoxycholate bile salts on breast cancer cells proliferation and survival. Mol Biol Rep 2020; 47:3521-3539. [PMID: 32297292 DOI: 10.1007/s11033-020-05442-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 04/06/2020] [Indexed: 11/24/2022]
Abstract
Bile acids (BAs) are bioactive molecules that have potential therapeutic interest and their derived salts are used in several pharmaceutical systems. BAs have been associated with tumorigenesis of several tissues including the mammary tissue. Therefore, it is crucial to characterize their effects on cancer cells. The objective of this work was to analyse the molecular and cellular effects of the bile salts sodium cholate and sodium deoxycholate on epithelial breast cancer cell lines. Bile salts (BSs) effects over breast cancer cells viability and proliferation were assessed by MTS and BrdU assays, respectively. Activation of cell signaling mediators was determined by immunobloting. Microscopy was used to analyze cell migration, and cellular and nuclear morphology. Interference of membrane fluidity was studied by generalized polarization and fluorescence anisotropy. BSs preparations were characterized by transmission electron microscopy and dynamic light scattering. Sodium cholate and sodium deoxycholate had dual effects on cell viability, increasing it at the lower concentrations assessed and decreasing it at the highest ones. The increase of cell viability was associated with the promotion of AKT phosphorylation and cyclin D1 expression. High concentrations of bile salts induced apoptosis as well as sustained activation of p38 and AKT. In addition, they affected cell membrane fluidity but not significant effects on cell migration were observed. In conclusion, bile salts have concentration-dependent effects on breast cancer cells, promoting cell proliferation at physiological levels and being cytotoxic at supraphysiological ones. Their effects were associated with the activation of kinases involved in cell signalling.
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Affiliation(s)
- Yamila B Gándola
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina.,Departamento de Química Biológica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956 (1113), Buenos Aires, Argentina
| | - Camila Fontana
- Departamento de Química Biológica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956 (1113), Buenos Aires, Argentina
| | - Mariana A Bojorge
- Departamento de Química Biológica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956 (1113), Buenos Aires, Argentina
| | - Tania T Luschnat
- Departamento de Química Biológica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956 (1113), Buenos Aires, Argentina
| | - Marcela A Moretton
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina.,Facultad de Farmacia y Bioquímica, Departamento de Tecnología Farmacéutica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Diego A Chiapetta
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina.,Facultad de Farmacia y Bioquímica, Departamento de Tecnología Farmacéutica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Sandra V Verstraeten
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina.,Departamento de Química Biológica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956 (1113), Buenos Aires, Argentina
| | - Lorena González
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina. .,Departamento de Química Biológica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956 (1113), Buenos Aires, Argentina.
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Henry RG, Raybould TP, Romond K, Kouzoukas DE, Challman SD. Clonidine as a preoperative sedative. SPECIAL CARE IN DENTISTRY 2018; 38:80-88. [PMID: 29364538 DOI: 10.1111/scd.12269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to -examine the use of oral clonidine as a preoperative sedative prior to parenteral moderate sedation. Initially, four patients were given 0.2 mg oral clonidine but reduced to 0.1 mg clonidine due to -significant drops in blood pressure. Oral clonidine doses of 0.1 mg were then given to 19 patients preoperatively. In all these patients, blood pressure measurements decreased, but there were no significant differences in amounts of sedative agents needed in the clonidine group and the control group (N = 80). The conclusions reached suggest that clonidine has an advantage over other preoperative sedation agents in anxious patients exhibiting hypertension and tachycardia. However, the preop ideal dose required to reduce the amount of sedative drugs used as well as provide anxiolysis remains unknown. In further studies, different doses should be explored to determine what dosage of clonidine may offer hemodynamic protection as well as decrease sedative drugs needed.
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Affiliation(s)
- Robert G Henry
- Chief of Dental Services, Department of Veterans Affairs Medical Center, Lexington, Kentucky and Associate Professor, College of Dentistry of Kentucky, Lexington, Kentucky
| | - Ted P Raybould
- Program Director, Kentucky Clinic and Professor, College of Dentistry, University of Kentucky, Lexington, Kentucky
| | - Kelli Romond
- Director of Dental Research, Staff Dentist, VA Dental Service, Department of Veterans Affairs Medical Center, Lexington, Kentucky
| | - Dimitrios E Kouzoukas
- Research Assistant Professor, Department of Molecular Pharmacology & Therapeutics, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois
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Wilson CJ, Mitchelson AJ, Tzeng TH, El-Othmani MM, Saleh J, Vasdev S, LaMontagne HJ, Saleh KJ. Caring for the surgically anxious patient: a review of the interventions and a guide to optimizing surgical outcomes. Am J Surg 2015; 212:151-9. [PMID: 26138522 DOI: 10.1016/j.amjsurg.2015.03.023] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 03/18/2015] [Accepted: 03/29/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Preoperative surgical anxiety is an unpleasant and common reaction exhibited by patients who are scheduled for surgical procedures. Beyond emotional effects on the patient, it can also have negative repercussions on the surgery including longer hospital stays and poorer outcomes. Given the widespread impacts of preoperative anxiety, it is critical for surgeons to gain a better understanding of how to identify and reduce surgical anxiety in their patients. DATA SOURCES This study used the PubMed database to review the current literature to evaluate screening tools and interventions for surgically anxious patients. CONCLUSIONS Psychiatric anxiety surveys are currently the most appropriate form of assessment for surgical anxiety. Patient education is important for preventing and reducing anxiety levels in patients. Both nonpharmacological and pharmacological interventions have been shown to be effective in reducing patient anxiety and treatment should be based on patient preference, resources available, and the surgeon's experience.
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Affiliation(s)
- Craig J Wilson
- Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Andrew J Mitchelson
- Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Tony H Tzeng
- Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Mouhanad M El-Othmani
- Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Jasmine Saleh
- National Institute on Deafness and other Communicable Disorders, National Institute of Health, Bethesda, MD, USA
| | - Sonia Vasdev
- Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Hillary J LaMontagne
- Department of Psychiatry, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Khaled J Saleh
- Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA.
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Chen Q, Wang L, Ge L, Gao Y, Wang H. The anxiolytic effect of midazolam in third molar extraction: a systematic review. PLoS One 2015; 10:e0121410. [PMID: 25849859 PMCID: PMC4388717 DOI: 10.1371/journal.pone.0121410] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 02/13/2015] [Indexed: 11/30/2022] Open
Abstract
Purpose To assess the efficacy of midazolam for anxiety control in third molar extraction surgery. Methods Electronic retrievals were conducted in Medline (via PubMed, 1950-2013.12), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 3), Embase (via OVID 1974-2013.12), and the System for Information on Grey Literature in Europe (SIGLE). The bibliographies of relevant clinical trials were also checked. Randomized controlled trials satisfying the inclusion criteria were evaluated, with data extraction done independently by two well-trained investigators. Disagreements were resolved by discussion or by consultation with a third member of the review team. Results Ten studies were included, but meta-analysis could not be conducted because of the significant differences among articles. All but one article demonstrated that midazolam could relieve anxiety. One article demonstrated that propofol offered superior anxiolysis, with more rapid recovery than with midazolam. Compared with lorazepam and diazepam, midazolam did not distinctly dominate in its sedative effect, but was safer. Two articles used midazolam in multidrug intravenous sedation and proved it to be more effective than midazolam alone. Conclusion It was found, by comparison and analysis, that midazolam might be effective for use for anxiety control during third molar extraction and can be safely administered by a dedicated staff member. It can also be used with other drugs to obtain better sedative effects, but the patient’s respiratory function must be monitored closely, because multidrug sedation is also more risky.
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Affiliation(s)
- Qi Chen
- State Key Laboratory of Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Stomatology Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lufei Wang
- State Key Laboratory of Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Stomatology Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lina Ge
- State Key Laboratory of Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Stomatology Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuan Gao
- State Key Laboratory of Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Stomatology Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hang Wang
- State Key Laboratory of Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Stomatology Hospital, Sichuan University, Chengdu, Sichuan, China
- * E-mail:
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Silveira-Souto ML, São-Mateus CR, de Almeida-Souza LM, Groppo FC. Effect of Erythrinamu lungu on anxiety during extraction of third molars. Med Oral Patol Oral Cir Bucal 2014; 19:e518-24. [PMID: 24880443 PMCID: PMC4192578 DOI: 10.4317/medoral.19511] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 12/27/2013] [Indexed: 12/02/2022] Open
Abstract
Objectives: The aim of the present study was to evaluate the effect of Erythrina mulungu on the control of dental anxiety in patients who had under gone bilateral extraction of asymptomatic, impacted mandibular third molars. Material and Methods: In a randomized, double-blind, crossover study, 30 healthy volunteers (5 men and 25 women, over 18 years of age), received either 500mg of E.mulungu (Mulungu Matusa®) or 500 mg of placebo, p.o., one hour before surgical procedure. The level ofanxiety was assessed through questionnaire sand physical parameters, such as blood pressure, heart rate andoxygen saturation. Data were analyzed by Chi-square test, ANOVA (Tukey test) and Friedman with significance level of 5%.
Results: A higher preference (Chi-square, p = 0.0062) for E. mulungu was observed for both genders. Volunteers with higher anxiety levels tended to to prefer E. mulungu. No statistically significant differences were verified in blood pressure (one-way ANOVA, p = 0.1259), heart rate (Friedman, p> 0.05) and oxygen saturation (Friedman, p = 0.7664) among periods and types of treatments.
Conclusions: E. mulungu showed an anxiolytic effect without significant changes in physiological parameters. It could be considered as an alternative to control the anxiety in adult patients undergoing mandibular thirdmolars surgery.
Key words:Anxiety, Erythrina mulungu, third molar, oral surgery.
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